Sarcoidosis

Sarcoidosis is a very rare condition in children. Certain factors may increase a child's likelihood for developing the condition:

• Race. African-Americans are about 10 times more likely to develop sarcoidosis than are Caucasians. Also, the condition is more likely to be more severe and cause lung problems in African-Americans.
• Family history. Although no gene has been identified as the cause of sarcoidosis, research has shown that a child is two to three times more likely to develop sarcoidosis if someone in his or her family has the condition.

The most common symptoms of sarcoidosis in children are uveitis (inflammation of the middle layer of the eye), arthritis and unexplainable rashes. Other early symptoms of sarcoidosis include:

• Swelling or pain in the joints
• Difficulty moving the joints
• Fatigue
• Fever
• Swollen lymph nodes
• Weight loss

Nearly all children affected by sarcoidosis eventually have lung problems such as:

• Persistent dry cough
• Shortness of breath
• Wheezing
• Chest pain

Many children who have the condition also develop skin problems such as:

• Rash. Children with sarcoidosis can develop a rash (often on the shins or ankles) of red or reddish-purple bumps that may be warm or tender to the touch.
• Lesions. Children with the condition may develop disfiguring skin sores, often on the nose, cheeks and ears.
• Color change. Some areas of skin can get darker or lighter in color.
• Nodules. Children with sarcoidosis can develop growths just under the skin, often around scars.

Some children with sarcoidosis have symptoms related to their eyes, including:

• Blurred vision
• Eye pain
• Severe redness
• Sensitivity to light

Diagnosis of Sarcoidosis

Sarcoidosis can be difficult to diagnose, because the condition produces few symptoms in its early stages and can affect any system in the body. In order to accurately diagnose sarcoidosis, doctors at Riley at IU Health perform one or more of the following tests:

• Physical exam. The doctor will begin with a physical exam, including a thorough examination of any skin lesions, the heart, the lungs and the lymph nodes.
• X-ray. Your child’s doctor may use an X-ray to check for lung damage or inflamed lymph nodes.
• Computed tomography (CT). Your child’s doctor may use a noninvasive CT scan to obtain a closer look at the lung tissue and lymph glands.
• Positron emission tomography (PET). A type of nuclear medicine imaging called positron emission tomography (PET) can help your child’s rheumatologist determine the exact location and amount of inflammation in the body.
• Magnetic resonance imaging (MRI). Your child’s doctor may use magnetic resonance imaging if sarcoidosis appears to be affecting either the heart or brain and nervous system.
• Blood test. A sample of your child’s blood may be analyzed to check kidney and liver function. There are a couple of enzymes that might be higher in the blood of people with sarcoidosis than healthy people. If the enzyme level is high, that supports the diagnosis. However, if the enzyme level is not high, it still could be sarcoidosis.
• Pulmonary function test. Your child’s lungs can be assessed for volume and the amount of oxygen the lungs deliver to the blood.
• Eye exam. An eye exam can check for any unexplained inflammation or vision problems that are associated with sarcoidosis.
• Biopsy. Your child’s doctor may take a biopsy (small sample of tissue) from an affected area of the body to check for granulomas (inflammation) commonly seen under the microscope in this condition.